[HN Gopher] Botulinum toxin: Bioweapon and magic drug (2010)
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       Botulinum toxin: Bioweapon and magic drug (2010)
        
       Author : redbell
       Score  : 46 points
       Date   : 2023-07-22 13:46 UTC (9 hours ago)
        
 (HTM) web link (www.ncbi.nlm.nih.gov)
 (TXT) w3m dump (www.ncbi.nlm.nih.gov)
        
       | sambeau wrote:
       | And yet people continue to inject it into their faces, because
       | wrinkles.
       | 
       | -\\_(tsu)_/-
        
         | [deleted]
        
         | [deleted]
        
         | bluepod4 wrote:
         | Digitalis/Digoxin/Lanoxin is a life-saving drug that is derived
         | from the toxic Foxglove plant and can still poison someone in
         | sufficient quantities according to Agatha Christie and the
         | internet. (I guess lots of drugs can harm you in sufficient
         | quantities lol.)
        
           | swayvil wrote:
           | Hey I grow foxglove in my garden. Lovely.
           | 
           | Here's another one : CASTOR OIL PLANT. Pretty common. Has
           | these beans.
           | 
           | Take some of the beans. Soak em in water for a couple days
           | and you have a fabulous poison : ricin.
           | 
           | Excruciating tummy ache and bloody diarrhea. Then you die.
           | 
           | https://en.m.wikipedia.org/wiki/Ricinus
        
             | bluepod4 wrote:
             | I wasn't aware of the castor oil plant's beans.
             | 
             | My good old friend Calabar Bean came to visit last week
             | though (Cain's Jawbone reference).
        
         | mdip wrote:
         | I saw the title and that was the _first_ thing I thought of.
         | 
         | I was _sincerely_ hoping that  "magic drug" wasn't referring to
         | its use in cosmetic surgery[0].
         | 
         | As I'm not a member of anything medical-field related I was
         | unaware that it had been used to treat "blepharospasm"[1].
         | Having gone through that _to the point of actually seeking
         | treatment_ , I'm disappointed my doctor wasn't aware of that
         | option. At the point -- two days with no sleep -- I would have
         | raided the drawers and given _myself_ a shot.
         | 
         | But, really, Botox is what most people think of when thinking
         | "magic drug." I'm not sure that's the word I'd use.
         | 
         | I'm a guy in my 40s with a pretty typical subset of people
         | categorized as "I used to know them in High School". Literally
         | in the period of 4 years about 25% of the women in my friends
         | list were _very clearly talked into getting Botox_. One woman
         | must be involved in some multi-level marketing scam related to
         | Botox because she 's frequently posting pictures of her face
         | "post treatment" (and, I'm sorry, it's grizzly)
         | 
         | I _have_ to believe that _some_ people have good results. But,
         | no joke, I can pick out at least 10 women who have what I call
         | "Botox Face". You notice it first in the lips -- "permanent
         | semi-duck-face". Then they start talking -- large portions of
         | their face don't move as expected. I had a co-worker who had it
         | done, missed a few days of work, and when she returned I had
         | assumed she suffered a _stroke_ (thank God I didn 't say
         | anything). I had known she had Botox before (she had the lips
         | already) so this was a second course of treatment.
         | 
         | Despite how this sounds, this wasn't intended as an attack on
         | folks who use Botox. I'm truly curious -- it seems like a _lot_
         | of people have this done and the results are _much_ worse than
         | before for _many_ of them. How many is anyone 's guess ... in
         | theory, it would be impossible to tell the difference between
         | good Botox and "natural" but I can't think of another form of
         | cosmetic surgery that has worse results. But considering _how
         | many_ people have bad results, why do _so many people continue
         | to get it done_ (including folks who _previously_ had bad
         | results!)
         | 
         | [0] Ok, maybe just a little, because it's an "easy target".
         | 
         | [1] Such a fun word -- one that people know if they've ever had
         | their eye twitch consistently for a month (try sleeping that
         | way).
        
           | rahimnathwani wrote:
           | "Having gone through that to the point of actually seeking
           | treatment, I'm disappointed my doctor wasn't aware of that
           | option."
           | 
           | This is really surprising. If you Google 'blepharospasm
           | treatment' and read a few articles, it's impossible not to
           | come across Botox. And this isn't even recent... About 20
           | years ago, I did a project related to commercializing an
           | innovative treatment of blepharospasm, and I recall
           | contrasting this new treatment against the alternatives
           | available at the time. Botox was one of them.
        
           | poorselfimage wrote:
           | [flagged]
        
           | AbrahamParangi wrote:
           | I think people see the pictures and it looks like it might be
           | an improvement but it's the motion of expressions that really
           | makes it look weird/uncanny. A human face is always moving
           | and it reads very wrong to see it move wrong.
        
           | chownie wrote:
           | Misunderstanding of Botox procedure aside ("duck" lips being
           | filler rather than Botox), is this just not a restatement of
           | the toupee fallacy?
        
             | spondylosaurus wrote:
             | Probably. IIRC the price of Botox injections has come down
             | a _lot_ in recent years, and it 's a relatively safe
             | outpatient procedure, so if social media trends are
             | anything to go by I'd assume quite a few people are getting
             | it.
             | 
             | Any good cosmetic work should be almost invisible to
             | someone who isn't looking at a before-and-after photo. I
             | recently got some work done (long story, but one of the
             | best decisions I've ever made) and my doctor said he
             | strives to do work that's so discreet no one will notice
             | and so gratifying that you'll tell everyone anyway.
        
           | JumpCrisscross wrote:
           | > _You notice it first in the lips -- "permanent semi-duck-
           | face"_
           | 
           | This is filler. Botox doesn't plump out features. (I've never
           | had botox, but I have friends who have. The difference
           | between discount and top-tier Manhattan plastic surgeon
           | administration is noticeable. Or, I suppose, not.)
        
           | jnovek wrote:
           | Fun fact: cosmetic Botox led directly to the discovery that
           | it could be used to treat chronic migraine -- some people who
           | received it for cosmetic reasons noticed that it improved
           | their headache symptoms and reported this to their doctors.
        
             | ianai wrote:
             | I was in Botox for migraine in the early days. Had more
             | than one conversation with someone who was clearly mistaken
             | that I'd said I was taking Botox for cosmetic purposes very
             | probably because they had. Made for a funny conversation,
             | but not bad. And others asking whether it's like cosmetic
             | Botox.
             | 
             | I'll be forever grateful to the people who noted it helped
             | their headaches!! I don't want to imagine how different my
             | life would be without it.
        
       | Glench wrote:
       | Huh, didn't realize botox could be an effective bioweapon.
       | 
       | I get regular botox injections to help with my headaches. It
       | works really really well. Takes a couple weeks to kick in then
       | lasts for a couple months before dissipating naturally.
        
         | hwillis wrote:
         | The Botox-like family are the most potent _substances_ by
         | weight, whether they 're used for medication or poison. It's
         | kind of crazy when you consider it. It takes thousands of botox
         | doses to kill you. That's not dissimilar from most drugs- take
         | a thousand advil and you'll certainly die.
         | 
         | One unit dose of botox is 50 _picograms_. A lethal
         | intramuscular dose is ~160 nanograms. A lethal inhaled dose is
         | ~1 microgram. That 's _crazy_. Inject any other chemical into
         | the heart, brain, wherever you want- you will not be able to
         | kill someone with a smaller dose of anything.
         | 
         | The next most potent drugs (eg LSD, actually) create
         | perceptible effects at _fifty times the lethal dosage of
         | botox_. LSD is noticeable at  <25 micrograms. Ricin is lethal
         | at 1.6 milligrams. Fentanyl is lethal at 2 milligrams and dosed
         | at 50 micrograms.
         | 
         | Even covid the vaccines have 30+ micrograms of RNA that _makes_
         | the larger amount of protein that trains your immune system. 50
         | picograms is only ~50,000 individual virus, about _half_ of
         | what is released by the infection of a _single cell_.
         | 
         | Botox is within spitting distance of the lethality of a
         | _nuclear fission reaction_. 160 nanograms of U-235 releases ~16
         | kJ, a bit under the energy in two AA batteries or ten 5.56
         | rifle shots. That 's more than enough energy to cauterize a
         | critical cardiac artery, or pop your skull... but it's less
         | than an M80.
         | 
         | Realistically (lol) if you pulled 160 nanograms of material
         | from the center of our sun (or probably any star short of a
         | neutron star), it's going to stop fusing immediately since
         | it'll be too busy exploding. I've got no idea what the math on
         | that is, but I'd be pretty surprised if it beat out botox for
         | lethality. Which is crazy.
        
         | loa_in_ wrote:
         | What muscles does your treatment target? It's pretty surprising
         | to me that it helps with headaches. I'm very curious, and very
         | interested in getting rid of headaches of my own.
        
           | Glench wrote:
           | It varies per person, but for me, surprisingly, muscles in
           | the occiput, temples, and around the trapezius. It was
           | amazing for me to realize that tension in my shoulders, back,
           | and neck could contribute to headaches, but it really is all
           | interconnected.
        
             | bluepod4 wrote:
             | Did you have other options for relieving that tension? Or
             | was Botox the most effective?
        
       | jnovek wrote:
       | Botox for migraine absolutely changed my life. I went from almost
       | continuous daily migraines to 2 or 3 4-hour migraines per week.
       | 
       | Each treatment is progressively more effective, this change
       | happened for me over the period of a year.
       | 
       | It got me to a point where I could show up at the gym and,
       | between those two things, I've been back to work full-time again.
        
         | IndigoIncognito wrote:
         | I used to get debilitating monthly headaches, they faded and
         | stop happening over a few years with no change in diet or
         | lifestyle. The brain is very strange
        
         | gehwartzen wrote:
         | I've been thinking about doing this for a while. I grind and
         | clench my teeth quite a bit at night. How often did you have to
         | get it done? Did your insurance cover it or is this something
         | you can use HSA money for? What's your cost per treatment?
         | 
         | Also does it in any way effect your chewing strength or ability
         | to make the full range of facial expressions?
         | 
         | Many Thanks!
        
           | jnovek wrote:
           | Insurance covers it, but I had to try (I think) four other
           | treatment modalities and show that they weren't sufficient
           | first.
           | 
           | My neurologist is really tuned into the insurance process
           | because she's seen Botox help so many people and we were able
           | to eliminate four modalities in about a year.
           | 
           | If you aren't lucky enough to have a doctor willing to play
           | the insurance game, you might have to do your own legwork
           | with insurance but, at least in my experience, it's worth it.
           | 
           | Edit: forgot to mention -- I'm lucky enough not to deal with
           | bruxism so I don't get injections low enough in my face to
           | know if it affects jaw strength. Mine are mainly in my scalp,
           | shoulders and forehead. It does reduce the expressiveness of
           | my forehead a little bit, but I consider it a fair trade
           | considering the alternative.
        
             | ianai wrote:
             | I have the impression from my neurologist that insurance
             | companies are now steering patients towards the
             | prophylactic cgrp blockers like Ajovy. It's got to be much
             | cheaper to give a patient a self injectable than pay a
             | neurologist for dozens of injections. Personally I'd much
             | rather not risk the headaches coming back to make a change.
        
         | bluepod4 wrote:
         | Does your neurologist have any idea what's causing the
         | migraines?
        
           | ianai wrote:
           | Some find where to inject with a radio signal and electric
           | probes. It can hear the firing of muscles. If you're relaxed
           | and it's still firing that's where to inject.
           | 
           | Migraines are caused by many things. But having screwed up
           | trapezious muscles probably contributes to many.
        
             | zer8k wrote:
             | I don't normally get migraines but I'd like to second that.
             | When I do get a debilitating migraine it is always
             | originating from my trap.
        
         | [deleted]
        
       | Xenoamorphous wrote:
       | I think it was in a Michael Crichton book that I read that
       | something like a couple of pounds of this toxin would be enough
       | to kill all mankind and that stuck with me. No idea if it's
       | accurate though.
       | 
       | Also I guess in terms of toxins a couple of pounds is _a lot_.
        
         | bigmattystyles wrote:
         | I think it has the lowest known LD50. The amount they must
         | dilute it by would probably make homeopaths blush.
        
       | 1-6 wrote:
       | Botox may also be a helpful tool against seizures:
       | https://pubmed.ncbi.nlm.nih.gov/28475998/#:~:text=After%20bo....
        
       | tristor wrote:
       | I have severe bruxism and Botox treatments of my masseter muscle
       | has made a huge difference. It's something I was very reluctant
       | about initially but I'm glad I ultimately tried it.
        
       | myself248 wrote:
       | Seems like a good thread to ask (I brought this up a few weeks
       | ago too): Why not use little bits of botox to prevent wisdom
       | teeth from growing in the first place? It'd be a heck of a lot
       | less invasive than removing them later.
        
         | folli wrote:
         | I don't understand: why would botox prevent wisdom teeth from
         | growing? I fail to see the connection.
        
         | dan-robertson wrote:
         | How common is it to need wisdom teeth removed these days? Eg
         | mine came up slowly but having them out wasn't even something I
         | discussed with my dentist
        
           | agurk wrote:
           | I would hazard a guess that you and GP live in different
           | countries. In Europe it is generally rare to remove wisdom
           | teeth after the mid 20s, as if they haven't caused acute
           | problems while erupting then they probably won't.
           | 
           | In the US it is a routine procedure to remove wisdom teeth
           | that would be considered healthy and non-problematic
           | elsewhere, even in older adults.
           | 
           | Source: my mother is dentist, and I've known multiple people
           | move to the US and suddenly as a middle aged adult need their
           | wisdom teeth removed.
        
             | unsupp0rted wrote:
             | Dentists have been telling me to remove my wisdom teeth for
             | about 15 ~ 20 years so far and I keep not seeing a reason
             | to
        
               | User23 wrote:
               | The best reason is that Beechcraft Bonanza your dentist
               | wants isn't going to pay for itself.
               | 
               | For some reason Americans are more enthusiastic about
               | unnecessary medical interventions. The pediatric ear tube
               | surgery is another example.
        
               | verall wrote:
               | If you're going to a normal dentist in USA then they
               | don't even do wisdom teeth, that's done by an oral
               | surgeon.
        
               | MattRix wrote:
               | Are there no referral fees for such things? I always
               | assumed that there must be.
        
             | proto_lambda wrote:
             | That's an interesting parallel to circumcision, which is
             | also an unnecessary routine procedure in the US, but
             | generally only done for acute medial reasons in Europe
             | (ignoring Muslims who do it for religious reasons
             | presumably in both).
        
         | thangngoc89 wrote:
         | Wisdom teeth started growing at the age of 14-15. Are you
         | willing to inject botox to your child?
        
           | JumpCrisscross wrote:
           | > _Are you willing to inject botox to your child?_
           | 
           | You're framing this as if it's a mortal sin to administer
           | medicine to children. Botox is well studied. If there is
           | medical benefit, it would be fine.
        
             | nilespotter wrote:
             | Actually, he just asked a question.
        
         | mdip wrote:
         | That's a pretty fantastic idea!
         | 
         | Of course, I'm far from an expert in anything related to
         | medicine and I'm sure there's some reason this is
         | dangerous/wouldn't work but I'd love to know why...
        
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